The Advantage of Colonoscopies
- Singer-songwriter and guitarist Raul Malo’s has revealed his doctors are “pleased” with his treatment process as he continues fighting colon cancer, a disease he announced he was diagnosed with earlier this summer.
- Colonoscopies are the most effective way to screen for colon cancer, according to our experts.
- The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
- The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
Malo, who has three sons with his loving wife Betty, recently took to social media to share the positive news and a new photo of himself going through treatment. Although it’s unclear what stage cancer he’s battling, it’s wonderful to see the musician staying hopeful and continuing to play music through treatment.
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Malo then revealed his second round of chemotherapy is “history now” and his doctors were happy with how he’s progressing.
He explained, “All the bloodwork and health signs are pointing in the right direction. The only side effect this week was just an overwhelming sensation to lay down and do nothing.
“Which is just about impossible for me but I’m managing…lol. Today on Saturday I’m feeling really good and I’m probably going to take my dogs for a walk, play some guitar, etc…”
Malo concluded by thanking his fans, friends, and loved ones, as well as promising to see them soon, adding, “Remember to get yourself checked out by your doctor.
“Don’t put it off any longer.”
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Malo’s followers were very pleased to hear the news and urging him to take an ample amount of time to rest, something which can be seen in the comments section of his post.
“As your fans, we appreciate the updates so much! Continue to take extra good care of yourself,” one fan wrote. “We all want you to put your health first so you can still be pickin’ and grinnin’ at 91 like Willie!!
Another fan commented, “Just seeing how much energy you put into every day on and off stage nonstop makes me wanna lay down just thinking about it.
“Rest up bubba and we love ya and can’t wait to try and keep up with ya when you kick the crap outta this jawn.”
A third wrote, “So happy for you that you’re doin so wonderfully. Thank you for letting us all know how you’re doing. Sending good vibrations your ways, loving hugs and prayers filled with lots of love too.”
Raul Malo’s Cancer Journey
Earlier this summer, Malo revealed he was battling colon cancer and urged his supportive fanbase to followup with their doctors and get all necessary checkups/cancer screenings.
Malo urged in a video clip shared on his social media page, “Part of the health journey is to get yourself checked out. Go to a doctor, take a physical.”
He revealed doctor’s had discovered “two cancerous spots” while undergoing a colonoscopy, which screens for colon cancer and prompted additional testing testing. The singer ultimately learned he had colon cancer.
“One of the reasons I’m telling you all this is that some of the shows may be affected this year as we navigate this situation and see how the therapy goes,” Malo explained.
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Aside from his treatment plans, Malo insisted he would continue to perform with his band when possible, adding, “Most people continue working and doing their daily activities.” Taking part in normal day-to-day activities amid treatment may be possible for Malo, we must remember this is not the case for everyone. However, we are happy to see Malo’s continued joy for life and doing what he loves mid-treatment.
Expert Resources on Colorectal Cancer
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Alcohol Intake Has a Big Impact on Colon Cancer Surgery
- A Coffee Enema Will Not Prevent Colon Cancer
- ‘You Shouldn’t Die From Embarrassment’: Colon Cancer Can Be Prevented
- Why a Tailored Approach to Colon Cancer Treatment Matters
- How Is Rectal Cancer Treated Differently Than Colon Cancer?
- How to Approach Treatment for Advanced Colon Cancer
- Treating a Bowel Obstruction Caused by Colon Cancer
Understanding Colon Cancer
Dr. Heather Yeo, a colorectal surgeon and surgical oncologist at Weill Cornell Medicine and New York-Presbyterian, previously told SurvivorNet, “Colon cancer is considered a silent and deadly killer.
“What happens is people often don’t know that they have colon cancer. They don’t have any symptoms. That’s why we screen for colon cancer in the United States.”
The Rate of Colon Cancer is Increasing in Those Under 50
“You should be screened for colon cancer, even if you have no family history. Once you have your initial screening colonoscopy, if there are no polyps and you have no high-risk factors, usually once every 10 years is fine,” she advises.
“Colon cancer is a slowly progressing cancer. If you have any family history of colon cancer, you should be screened about 10 years before your family member had colon cancer. So if you have a family member that was 53, you should be screened at 43.”
Colon Cancer Appearing More in Younger People
Although the average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society, the National Cancer Institute reports that since the 1990s, colorectal cancer cases have been rising among adults younger than 50.
Research published in CA: A Cancer Journal for Clinicians found the proportion of cases in people younger than 55 years old increased from 11% in 1995 to 20% in 2019.
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist and lead study author Rebecca Siegel said.
Researchers are still trying to determine why younger people are being diagnosed in greater numbers. Some experts point to risk factors which include obesity, physical inactivity, and smoking as a possible explanation for the increase.
“We don’t know for sure why we are seeing earlier onset and death from colon cancer,” Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, told SurvivorNet.
“It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors,” Dr. Yeo added.
Screening for Colon Cancer
Luckily, most colon cancers can be prevented through routine screenings. Colon cancer screenings usually involve a colonoscopy, in which a long thin tube attached to a camera is used to examine the colon and rectum.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test before they turn into cancer. If no polyps are discovered, the next screening won’t be needed for about 10 years.
Dr. Paul Oberstein Explains Common Colon Cancer Symptoms
A colonoscopy isn’t the only colon cancer screening test. There are other options, including stool tests that detect blood or DNA, and flexible sigmoidoscopy, which checks only the lower third of your colon.
Ask your doctor whether any of these tests would be good additions to a colonoscopy, based on your risks and/or personal preferences.
RELATED: Can the Stuff in My Gut Cause Cancer? There May Be A Link to Colon Cancer
“We know that colon cancers can be prevented when polyps are found early,” Dr. Yeo added. “Lowering the screening age helps somewhat with this, but access to care is a real problem.”
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
“The fact that we have now reduced the screening age to 45 is a huge step,” Michael Sapienza, CEO of Colorectal Cancer Alliance, told SurvivorNet in an earlier conversation.
“It will allow us to potentially screen 15 million more eligible Americans a year and will certainly save lives. I also think what it’ll do is bring much-needed attention that even if you’re younger than 45 you should be paying more attention. I think that’s also a really important message.”
Keeping Up With Recommended Screenings
As a part of routine care, people who have had colitis for eight years or more may get a colonoscopy to screen for colon cancer every one to three years, depending on their individual level of inflammation.
In the general population, guidelines recommend colon cancer screening once every ten years starting at age 45. Follow up screenings sooner than ten years are based on whether you have any abnormalities.
Dr. Heather Yeo Breaks Down Different Ways to Screen for Colon Cancer
Doctors use colonoscopies to check for abnormal growths (polyps) in the colon that can be cancerous or develop into cancer. People with colitis tend to develop a different kind of polyp than other people do, and these polyps are more likely to contain atypical or pre-cancerous cells.
“So those polyps are one step closer to developing into cancer, whereas a lot of the polyps we find in the general population are benign,” Dr. Limketkai said.
Crohn’s disease, however, is a little bit different. Because this condition can affect any part of the GI tract, Crohn’s disease only raises risk for colon cancer if the inflammation is in the colon, which varies from one person to the next.
Does inflammation cause any other types of cancer? Dr. Stephen Freedland explains.
“If it spares the colon, then we don’t have to do all the surveillance that we do in colitis,” Dr. Limketkai explained. “Of course, you may need to have colonoscopies for other reasons, and while you’re doing that, you’re getting a screening anyway.”
When it comes to inflammatory bowel disease, the major risk factor for colon cancer is untreated disease. Treatment, which may include a combination of medication, dietary changes and routine endoscopies, keeps inflammation under control. Sticking to that treatment can help keep colon cancer risk to a minimum, too.
Treating Colon Cancer at Stages One, Two and Three
When it comes to treatment for colon cancer at stages one, two and three, there is the potential for a curative effect with surgical resection.
Colon Cancer Stages One, Two and Three
“As long as it hasn’t spread outside of the local area, it’s still considered a curable colon cancer,” Dr. Yeo told SurvivorNet.
According to Dr. Yeo, all patients with stage one to three colon cancers undergo surgery “if they’re healthy enough to tolerate it.” But there’s more nuance to the possibility of additional treatment for stages two and three.
“Stage 2 a little bit more in between,” she said. “It really depends on kind of the depth of the tumor into the colon wall and the risk that it has to spread.
If a stage two colon cancer has “bad features” identified by a pathology report, chemotherapy might be the right move.
“For example, if when they look at the pathology slides under the microscope, if they see that it’s involving some of the vessels nearby, then that is a higher risk factor,” she explained. “And then, those patients might be more likely to benefit from chemotherapy.”
Stage three colon cancers have spread to the lymph nodes. So, these patients “at least need a conversation of chemotherapy,” according to Dr. Yeo.
“For our patients with 3 or higher, they all need chemotherapy,” Dr. Yeo said.
Treatment Advances
Meanwhile, a new promising treatment for late stage colorectal cancer may soon be available for patients in need of options. The Food And Drug Administration (FDA) is currently reviewing the drug fruquintinib, an oral treatment by Takeda Oncology.
Fruquintinib is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published in June showed the drug improved overall survival and progression-free survival, which is a measurement of the amount of time before the cancer comes back or spreads.
When found early, colorectal cancer has a great prognosis. If detected before it spreads, 90% of those diagnosed have a 5-year survival. That is why so much emphasis is put into screening. But for those who are in a later stage, the prognosis is grim and there has been very little progress in treatment development.
Once you get to the metastatic setting, many patients “they just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda, to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018, and was originally developed by Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong and Macau in January 2023.
Fruquintinib is an oral drug that inhibits angiogenesis, meaning it blocks the growth of blood vessels that increase tumor growth. It was investigated in two phase three trials for metastatic colorectal cancer.
“Both trials were robust large placebo controlled trials, and they both showed an overall survival advantage,” Elliott told SurvivorNet.
According to the study published in June, patients who received fruquintinib plus best supportive care (BSC) experienced 7.4 months of overall survival, compared to those who received a placebo plus BSC, who experienced 4.8 months of overall survival. And patients who received fruquintinib experienced 3.7 months of progression-free survival, over those who received placebo, who experienced 1.8 months of progression-free survival.
“I think what’s unique about fruquintinib is its manageable safety profile, as well as the fact that it didn’t decrease the quality of life of patients on the trial — which is really important in this late stage of disease,” Elliott told SurvivorNet.
The drug was granted Priority Review by the FDA and assigned a Prescription Drug User Fee Act (PDUFA) goal date of November 30, 2023. A marketing authorization application for the drug in Europe has also been validated.
Contributing: SurvivorNet Staff
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